Article(id=1322931433685266497, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931411006665649, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.13.023, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1744128000000, receivedDateStr=2025-04-09, revisedDate=1768838400000, revisedDateStr=2026-01-20, acceptedDate=null, acceptedDateStr=null, onlineDate=1793341032667, onlineDateStr=2026-10-30, pubDate=1783612800000, pubDateStr=2026-07-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793341032667, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793341032667, creator=13701087609, updateTime=1793341032667, updator=13701087609, issue=Issue{id=1322931411006665649, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='13', pageStart='2193', pageEnd='2384', issueExtLink='null', onlineDate='null', pubDate='1783612800000', pubDateStr='2026-07-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793341027261, creator='13701087609', updateTime=1793343114456, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940165425082661, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931411006665649, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940165425082662, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931411006665649, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2365, endPage=2369, ext={EN=ArticleExt(id=1322931433894981698, articleId=1322931433685266497, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application and consideration of digital whole-course management model in patients with colorectal cancer, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This review discussed the concept and advantages of the digital whole-course disease management model, classified and examined its applications in colorectal cancer patients,and explored considerations and future prospects.Suggestions are proposed to provide a reference for further advancing the development of the digital whole-course disease management model for colorectal cancer patients in China.

, authors=Wanting CAI1, Liande TAO1, Yuan ZHANG1, Yinghong HE2, Shiyu HUANG2, Xuemei CHEN3, authorsList=Wanting CAI, Liande TAO, Yuan ZHANG, Yinghong HE, Shiyu HUANG, Xuemei CHEN, authorCompany=null, correspAuthors=Liande TAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322931434180194371, articleId=1322931433685266497, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=数字化全病程管理模式在结直肠癌病人中的应用及思考, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=

就数字化全病程管理模式的概念及优势,在结直肠癌病人中的分类及应用、思考及展望进行综述,并提出建议,旨在为促进数字化全病程管理模式在我国结直肠癌病人中的进一步发展提供参考。

, authors=蔡琬婷1, 陶莲德1, *, *, 张源1, 何英洪2, 黄诗宇2, 陈雪梅3, authorsList=蔡琬婷, 陶莲德, 张源, 何英洪, 黄诗宇, 陈雪梅, authorCompany=null, correspAuthors=陶莲德, authorNote=

蔡琬婷,护士,硕士研究生

, correspAuthorsNote=
陶莲德,E-mail:
TAO Liande, E-mail:
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蔡琬婷,护士,硕士研究生

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蔡琬婷,护士,硕士研究生

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数字化全病程管理模式在结直肠癌病人中的应用及思考
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蔡琬婷 1 , 陶莲德 1, *, * , 张源 1 , 何英洪 2 , 黄诗宇 2 , 陈雪梅 3
护理研究 | 科研综述 2026,40(13): 2365-2369
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护理研究 |科研综述 2026 , 40 (13) : 2365 -2369
数字化全病程管理模式在结直肠癌病人中的应用及思考
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蔡琬婷,护士,硕士研究生

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蔡琬婷1, 陶莲德1, *, * , 张源1, 何英洪2, 黄诗宇2, 陈雪梅3
作者信息
  • 1宜宾市第二人民医院,四川 644000
  • 2川北医学院
  • 3成都中医药大学
通讯作者:
陶莲德,E-mail:
TAO Liande, E-mail:
作者简介:

蔡琬婷,护士,硕士研究生

Application and consideration of digital whole-course management model in patients with colorectal cancer
Wanting CAI1, Liande TAO1 , Yuan ZHANG1, Yinghong HE2, Shiyu HUANG2, Xuemei CHEN3
Affiliations
  • 1The Second People's Hospital of Yibin, Sichuan 644000 China
  • 2North Sichuan Medical University
  • 3Chengdu University of TCM
出版时间: 2026-07-10 doi: 10.12102/j.issn.1009-6493.2026.13.023
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就数字化全病程管理模式的概念及优势,在结直肠癌病人中的分类及应用、思考及展望进行综述,并提出建议,旨在为促进数字化全病程管理模式在我国结直肠癌病人中的进一步发展提供参考。

数字化  /  全病程管理  /  结直肠癌  /  综述

This review discussed the concept and advantages of the digital whole-course disease management model, classified and examined its applications in colorectal cancer patients,and explored considerations and future prospects.Suggestions are proposed to provide a reference for further advancing the development of the digital whole-course disease management model for colorectal cancer patients in China.

digitalization  /  whole-course disease management  /  colorectal cancer  /  review
蔡琬婷, 陶莲德, 张源, 何英洪, 黄诗宇, 陈雪梅. 数字化全病程管理模式在结直肠癌病人中的应用及思考. 护理研究, 2026 , 40 (13) : 2365 -2369 . DOI: 10.12102/j.issn.1009-6493.2026.13.023
Wanting CAI, Liande TAO, Yuan ZHANG, Yinghong HE, Shiyu HUANG, Xuemei CHEN. Application and consideration of digital whole-course management model in patients with colorectal cancer[J]. Chinese Nursing Research, 2026 , 40 (13) : 2365 -2369 . DOI: 10.12102/j.issn.1009-6493.2026.13.023
结直肠癌(colorectal cancer,CRC)是全球第三大常见恶性肿瘤[1]。据2024年全国癌症报告显示,我国新发癌症病例482.47万例,其中结直肠癌新发病例数由2018年的第3位攀升为第2位,共计51.71万例,死亡率也由2018年的第5位升为第4位,高达24%,是严重增加家庭和社会经济负担的一类恶性肿瘤[2-3]。随着人们生活水平的提高和生活方式的改变,结直肠癌的发病率和死亡率均呈上升趋势。结直肠癌诊疗方案复杂,涉及手术、放化疗、影像学评估、病理学评估、内镜检查等诊疗手段,病人常面临疾病本身与治疗带来的多重身心症状,导致其生存质量下降,亟须得到更多连续性、整体性的医疗护理服务[4]。如何长期、持续、连续、主动、有效地管理和控制结直肠癌病人的病情,是当前需要重点关注的问题,由此发展了一种新的病程管理模式,即全病程管理模式,其是以数字医疗为载体的新型数字化干预手段,为解决该问题提供了新思路。现就数字化全病程管理模式的概念及优势、在结直肠癌病人中的分类及应用、思考及展望等进行综述,旨在为促进数字化全病程管理模式在我国结直肠癌病人中的进一步发展提供参考。
随着医学研究及临床服务模式的发展,在临床护理工作中衍生出一系列新型的护理管理模式,其中全病程管理模式是近年来提倡的人性化干预模式,该模式涉及整个病程的多学科团队合作,为病人提供准确的诊断方法及治疗,并能识别重要的预后因素以随访,不仅包括手术、化疗和放疗等传统管理内容,还包括营养支持、心理咨询、疼痛管理和康复训练等,有助于改善病人健康状况及预后[5-6]。数字化全病程管理模式是一种基于互联网技术的创新医疗管理模式,该模式通过可穿戴设备、网站、移动应用程序(APP)等多元化数字渠道,构建覆盖病人全周期、多场景的疾病管理服务体系,可提升病人的疾病认知、优化治疗依从性、帮助病人改善生活质量、延缓疾病进展、降低疾病急性发作风险。其核心特征体现在:1)全流程覆盖,形成从疾病早期筛查、规范诊疗到院外随访、康复管理的完整闭环;2)多学科协同,打破传统医疗的时空限制,实现跨学科、跨团队的协同管理;3)全周期干预,贯穿病人诊前、诊中、诊后各环节,甚至延伸至临终关怀阶段[7-11]。
可穿戴设备管控型数字化全病程管理模式通过智能传感技术实现对结直肠癌病人的全方位健康监测[12]。该模式整合了多种先进的可穿戴设备(如生物传感器腕带、智能贴片等),持续采集病人的生命体征、活动轨迹、睡眠质量等健康数据,并通过5G/蓝牙等无线传输技术实现与医疗云平台的实时数据交互[13]。系统采用人工智能算法对病人数据进行智能分析,可精准识别病人异常生理指标并及时发出预警,从而帮助结直肠癌病人进行疾病的数字化全病程管理[14-15]。Van Blarigan等[16]针对结直肠癌病人开发了一套基于数字技术的全病程管理干预方案,该研究创新性地整合了短信提醒与Fitbit Flex智能腕带监测功能,构建了一个闭环式的健康管理系统。研究者以计划行为理论为指导,结合前期小组质性访谈的研究结果,为病人每日定时发送短信,短信内容包括身体活动的健康获益解析、个性化目标设定指导以及日常生活场景中的运动整合策略等。研究团队通过Fitbit Flex腕带持续采集42例受试者的多维运动数据(包括步数、移动距离、有效活动时长及能量消耗等指标),并利用云端同步技术实现跨平台数据整合。研究人员采用标准化流程,在干预的第4周、第8周、第12周3个时间节点系统性地获取并分析病人运动数据。研究结果显示,这种融合行为科学理论与可穿戴技术的数字化干预模式,能显著提升结直肠癌病人的日常活动水平,并改善其生活质量。此外,一项美国学者开展的双臂随机对照试验也为结直肠癌病人的全病程管理提供了重要的数字化干预策略[17]。该研究纳入44例接受化疗的结直肠癌病人,干预组病人通过佩戴Fitbit体力追踪器、使用家庭锻炼手机应用程序以及接收全自动短信通知,实现了从院内治疗到院外康复的全病程健康管理;而对照组仅接受常规护理。在12周的干预期内,干预组病人对Fitbit的依从性极高,89%的病人对Fitbit表示满意,63%对短信提醒表示满意;然而,该研究对结直肠癌病人身体活动的改善效果还有待进一步探究。
目前,可穿戴设备的整体兼容性较差,功能主要集中在症状监测等方面,导致其性价比不高且功能较为单一[18]。此外,可穿戴设备的有效性依赖于设备精度、数据安全性和医患协同机制三大关键要素,这要求建立标准化的设备认证体系和完善的隐私保护方案[19]。未来技术人员可加强数据加密技术的应用,如端到端加密和基于区块链的分布式存储技术,以保障结直肠癌病人在使用可穿戴设备时的隐私安全[20]。另外,国家应出台制定相关行业标准用于规范数据的采集、处理、存储和共享,帮助结直肠癌病人实现更精准、更便捷的全病程疾病管理。
移动医疗应用程序依托型数字化全病程管理模式是通过智能手机的第三方专业化移动医疗应用程序将各种医疗相关信息传递给用户,可为结直肠癌病人提供全方位的疾病管理支持[21-22]。Salmani等[23]开发了一款名为“Colorectal Cancer Along”的移动医疗应用程序,用于结直肠癌病人的全病程管理。该研究招募了17例结直肠癌病人,并对其进行为期2周的应用程序可用性评估。这款应用程序具有全面的功能设计,覆盖了结直肠癌病程管理的多个关键领域,包括病人个人健康档案管理、智能用药提醒系统、个性化营养指导方案、疼痛评估与管理工具、心理健康支持模块、戒烟限酒行为干预、疾病知识教育支持、自定义提醒和健康笔记等,且该应用程序支持离线使用,病人在无网络环境下仍能获取所需信息。结果显示,该应用程序获得了良好的用户满意度,能够有效提升结直肠癌病人的自我管理能力。该应用程序的离线功能设计尤其适合医疗资源相对匮乏地区的病人使用,为改善结直肠癌病人的疾病管理提供了新的数字化解决方案。Mayer等[24]基于自我决定理论开发了一款名为“Survivor CHESS”的移动医疗应用程序用于结肠癌病人的全病程管理,并在Ⅰ~Ⅲ期结直肠癌病人中实施了一项双臂、单盲的多中心随机对照试验。该应用程序包含四大模块。1)智能监测模块:监测活动记录并设定活动目标;2)社交支持模块:构建病人交友论坛与个人健康档案平台;3)运动指导模块:提供专业化的身体活动技能培训;4)信息支持模块:建立权威医疗资讯通道。同时,该应用程序还配备专业健身顾问团队为病人提供一对一指导,并将教练录制的训练视频通过随机轮播的方式在主界面展示。然而,结果显示干预组的生活质量、心理痛苦水平与对照组相比较,差异均无统计学意义,身体活动水平在干预6个月后也未明显提高,表明当前干预方案在改善结肠癌病人生活质量、心理状态和身体活动水平方面的效果有限,这可能与干预强度不足、用户依从性较低或评估周期较短等因素有关,提示未来研究需要优化干预策略的设计与实施。
虽然目前全球移动医疗应用程序的数量众多且呈快速增长趋势,但移动医疗应用程序的下载应用量较少,使用率较低[25]。移动医疗应用程序依托型数字化全病程管理模式在结直肠癌病人中的应用效果还有待进一步探究,影响该模式应用的因素有很多,如应用程序内容与病人需求出现偏差等。未来在移动医疗应用程序的开发过程中,研究者应对目标人群的健康需求进行系统化分析,可通过质性访谈及问卷调查等研究方法,对用户需求展开多维度探究,从而优化功能设计、提升用户体验,提升移动医疗应用程序的实际使用率与用户接受度[26]。为确保移动医疗应用程序的科学性与临床适用性,其开发过程应采用多学科协作模式,由具备专业资质的临床医护人员及相关领域专家共同参与内容制定,通过整合循证医学证据与权威临床指南,有效保障健康信息的准确性与可靠性,最大化发挥移动医疗应用程序的应用效益。
基于社交软件的数字化全病程管理模式可通过社交媒体平台整合现有资源,构建在线沟通与互助社群,为结直肠癌病人提供实时信息交流、健康决策支持及心理疏导等数字化全病程管理服务[27]。社交软件在促进医患互动及病人间交流方面具有显著优势,其能够以高效、低成本的方式实现健康信息的广泛传播,精准满足病人的多元化疾病管理信息需求[28]。Xia等[29]开展了一项单盲随机对照试验研究,将155例低位直肠癌术后病人随机分为试验组和对照组,对照组接受常规护理,试验组接受基于微信、博客、QQ等社交平台开展的医院-家庭一体化全病程管理模式干预。与对照组相比,试验组病人的自我效能感和生活质量得到改善,并发症发生率降低。于淼等[30]借助微信平台为直肠恶性肿瘤病人提供了全病程管理干预,该研究团队为病人制定了阶段性计划,包括饮食调控、规律排便训练、肠造口袋更换技术及扩肛操作等康复内容。同时,利用多媒体形式(文字、图片、语音及视频)向病人动态推送造口护理知识,结果显示,该干预模式有效减少了病人的术后并发症,提升了病人的生活质量。庞雪滢等[31]基于症状管理理论框架,开发了以微信小程序为载体的直肠癌低位前切除综合征全病程管理平台。该平台通过三大核心功能模块(症状评估系统、个性化管理策略推荐和动态疗效监测体系)为病人提供了一个全面、可靠的数字化全病程管理平台,该平台不仅有效解决了病人在症状自我管理中的核心诉求,还通过创新的远程监护系统和动态随访机制,降低了病人的再入院率和经济负担。尽管社交软件能通过互动交流与健康知识传播等方式满足结直肠癌病人的部分疾病管理需求,但现有网络信息的准确性与可靠性亟待验证[32]。未来监管部门应健全网络医疗信息审核机制,对误导性内容实施动态监测与及时修正;医疗专业人员应当积极构建权威的社交媒体平台,定期发布经循证医学验证的疾病管理知识。另外,当前社交软件等平台的功能开发仍显不足,未来需探索整合智能问诊、个性化推送等创新功能,以全面提升结直肠癌病人的全病程管理体验。
远程监测系统调控型数字化全病程管理模式是运用互联网远程监测系统对结直肠癌病人的身体症状进行实时监测指导,帮助病人进行数字化的全病程管理模式。Maguire等[33]招募了829例5年内首次接受一线辅助化疗或化疗的非转移性乳腺癌、结直肠癌、霍奇金病或非霍奇金淋巴瘤病人,开展了一项多中心、重复测量、平行组、评估者盲法的分层随机对照试验,评估了包括结直肠癌在内的多种癌症病人在化疗期间实施远程症状监测的效果。两组病人均接受6个周期以上的化疗,干预组接受症状管理系统的远程监测,对照组接受标准治疗,结果表明,两组病人在总体症状困扰指数、心理症状、躯体症状等方面均差异明显。干预组病人症状负担显著减轻,证明在癌症护理中进行远程症状监测对病人有积极的临床效用。Kearney等[34]通过远程监测高级症状管理系统对112例接受化疗的实体肿瘤(包括结直肠癌、乳腺癌和肺癌)病人进行数字化全病程管理。当病人在出现不适症状时,可通过移动终端完成症状自评,系统通过算法分析后即刻向病人手机推送个性化自我管理建议。同时,医疗团队通过医生端实时监控平台获取病人症状数据,帮助病人做出治疗决策,研究结果显示,该系统可减轻病人化疗相关并发症,帮助其进行症状管理。
远程监测系统的开发与应用需要较大的经济投入和较高的技术要求,未来还需要增加专业培训课程以提升各级人员对远程监测系统的开发、实施和维护的能力,同时配置必要的技术支持和资源保障,以确保系统全生命周期的可持续发展[35]。
数字化全病程管理模式在结直肠癌病人的疾病管理中展现出多方面成效,该模式可通过可穿戴设备、社交软件、移动医疗应用程序和远程监测系统,构建动态的监测-预警-干预-评估的闭环疾病管理系统,降低病人治疗的并发症发生率,并帮助病人改善身体活动功能。数字化全病程管理模式还可以帮助医生明确结直肠癌病人的治疗现状和治疗目标,及时发现治疗时的不良反应,通过提供标准化管理方法和工具,提高医患沟通效率和病人治疗依从性。
尽管数字化全病程管理模式为结直肠癌病人带来了显著的临床获益,但在实际推广过程中仍面临若干关键性挑战。首要障碍在于数字鸿沟问题,老年结直肠癌病人会因为电子健康素养不足而难以有效使用智能医疗设备;其次,数据安全风险尤为突出,只有少数的医疗机构配备了专职网络安全团队,多数基层医院使用的医疗物联网设备都存在安全漏洞,这些系统性风险会导致病人的诊疗数据面临被非法获取、篡改甚至勒索的威胁;此外,跨平台数据共享的需求与隐私保护之间也存在矛盾,多数病人对个人健康数据的使用范围表示担忧。未来需要加强数字化技术防护、增强网络安全的保障并加强群众的电子健康素养培训,同时开发适老化、无障碍的智能医疗界面,助力高质量数字化全病程管理模式在结直肠癌病人中的应用。

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2026年第40卷第13期
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doi: 10.12102/j.issn.1009-6493.2026.13.023
  • 接收时间:2025-04-09
  • 首发时间:2026-10-30
  • 出版时间:2026-07-10
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  • 收稿日期:2025-04-09
  • 修回日期:2026-01-20
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    1宜宾市第二人民医院,四川 644000
    2川北医学院
    3成都中医药大学

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陶莲德,E-mail:
TAO Liande, E-mail:
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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